You wish to resort to cosmetic surgery to increase the volume of your breasts and you hesitate, you ask yourself questions.
Here are the answers of Dr Christophe Desouches, cosmetic surgeon in Marseille, to the most frequent questions concerning breast implants, lipofilling, breast lift and cosmetic breast surgery in general.
As a reminder :
- Breast augmentation with implant consists of inserting silicone prostheses in the breast
- On the other hand, with the lipofilling, the increase in breast volume is achieved by injections of autologous fat (taken from the patient); therefore there is no use of foreign body to achieve the desired increase
Volume : lipofilling allows a moderate increase in volume (about a half to a cup). For a substantial increase, the implant will be used.
Breast ptosis : if it is moderate, the implantation may improve the ptosis. This is not the case with lipofilling.
Appearance : lipofilling and implant placement give a result that seems natural, as long as one remains reasonable at the level of the desired increase for the prostheses.
Scars : invisible for lipofilling, very reduced for breast implants, especially with minimally invasive methods.
Post operative reaction : although they are very rare, lipofilling avoids the use of a foreign body and therefore reduces any probability of reaction.
Duration of the result : in both cases the result is reliable and durable.
Women have been able to use breast prostheses for more than 60 years.
The breasts of women in industrialized countries are regularly monitored.
Numerous studies have been carried out on thousands of women who have benefited from breast augmentation by prosthesis (serum or silicone), in most industrialized countries.
None of these studies identified an incidence of breast cancer in women with breast prostheses.
In addition, prostheses are regularly used in the case of breast reconstruction after breast cancer.
Each patient has her specific expectations: natural and discreet appearance, or rounded effect; desired neckline, shape of the breasts; final cup size.
Dr Christophe Desouches, who has been practicing breast augmentation with various approaches for over 15 years, listens to your wishes during a first consultation, studies the specificities of your anatomy, in order to recommend the ideal volume to achieve your goals. In addition to the volume of the implants, their morphological characteristics will have a significant impact on the final result: the shape (round, anatomical, ergonomic), the profile, the projection, the dimension of the base, etc.
To give you a point of reference, the average of implants used in Europe would be around 300 cc, the equivalent of a well-filled C cup in bra size.
Beyond 600 cc, we find ourselves in a delicate situation, which can generate “mechanical” tensions and accelerate breast ptosis.
For the materials used, a distinction must be made between the envelope and the content:
- Silicone is You can choose between two types of breast prostheses : round implants and anatomical implants. The final choice depends on your wishes and the study performed by the surgeon, as mentioned in the previous question used for the envelope. Only the smooth or micro-textured envelope has been authorized by the ANSM since 2019
- Content can be silicone gel or hydrosaline solution (physiological saline)
Note: macro-textured silicone envelopes have been banned in France since 2019, as a precautionary principle.
Breast implants with physiological saline are filled with sterile salt water. They can be pre-filled to a predetermined size or filled at the time of surgery to allow for minor changes in the size of the implant. The advantages of this technique: harmlessness of the serum in the event of a leak, reduced incisions, fine balance of volumes in the event of asymmetry. This type of implant is nevertheless little used because it presents a less flexible and less natural aspect.
Silicone gel filled breast implants are filled with a soft, elastic, non-toxic gel, and are available in a wide variety of shapes. All silicone gel breast implants are pre-filled and may require a larger incision for insertion. This type of prosthesis is the most used, its lifespan can reach 15 years.
Depending on your medical history, your morphology and your aesthetic goals, Dr. Desouches will recommend breast implants in silicone or physiological serum.
The breast prosthesis market is booming and the marketing promises are often tempting. Experience and practice allow Dr Desouches to select the safest and best quality products.
According to the National Agency for the Safety of Medicines and Health Products, the lifespan of a breast prosthesis is approximately 10 years. It can last much longer, although after this period the risk of rupture is greater.
Dr Christophe Desouches will explain the various possibilities for introducing implants available to you to achieve your goals. Know that the final choice is yours.
The usual options are:
- The inframammary route, widely used because it provides convenient access, the discreet scar of which can however be noticed depending on the patient's arm movements or in a bikini
- The nipple areola border or even horizontally in the nipple which allows for a very inconspicuous scar, but which involves passing through the mammary gland
- The axillary approach whose scar is almost invisible (in the armpit), which requires specific know-how, especially when the implant is inserted between the mammary gland and the muscle.
Each patient has her sensitivity and her personality, and the feeling after an intervention can range from slight discomfort to more present pain. Depending on the type of operation, the patient may experience postoperatively:
- Bruises
- Numbness or changes in sensitivity (nipple)
- Itching around the incision sites
- Feeling of cramps
- Tensions in the thorax
- Back pain
These discomforts and moderate pain after breast augmentation can persist from a few days to a few weeks. To reduce them, the surgeon can recommend simple analgesics such as Paracetamol, possibly more powerful analgesics such as Codeine or even intravenous analgesics.
To note : axillary breast augmentation is generally not very painful. The discomfort that results from the procedure is similar to other implant methods. The pain is mainly due to the submuscular breast augmentation, the implants in front of the muscle in the subfascial position being much less painful.
the lipofilling, which consists of taking fat from the patient (buttocks, thighs, etc.) to reinject it after purification in the breast, is the breast augmentation technique considered the most natural.
Dr. Christophe Desouches will tell you how long it will take before you can return to your normal level of activity. This duration is 5 to 15 days depending on your professional activity.
For sports activities, it depends on their intensity:
- Light activities that strain the lower body in particular: one month
- Intense activities involving the pectorals: 2 to 3 months
Before breast surgery, it is recommended that you do not have any ongoing pregnancy plans. If you plan to have children within 2-3 years, you should postpone cosmetic breast surgery. Pregnancy can stretch the skin of the breasts and reduce their size, compromising the benefits of this surgery.
However, breastfeeding is possible because the prostheses are located behind the mammary gland regardless of the type of scars. The milk ducts or lactiferous ducts which allow the milk to be conveyed to the nipple are intact after this type of surgery.
Depending on the type of intervention (Breast prosthesis, Breast Ptosis (lifting), Breast lipofilling, Breast Ptosis and Lipofilling, Ptosis and breast prosthesis), prices vary between € 4,500 and € 5,200.
Social security generally does not take these interventions into account. Only breast atrophy (boy's chest) or tuberous breasts (malformed breasts with a very large areola) can be reimbursed.
Increasing the volume of the breasts by breast surgery is most of the time a purely cosmetic act. As a result, no support is envisaged by social security.
In all cases, the scars are small and usually hidden in the natural folds.
Transaxillary breast augmentation is a cutting-edge technique for placing breast implants while avoiding any visible scars on the breast. The scar in the armpit is one of the least detectable of all breast augmentation procedures. The incision is placed directly into one of the skin's natural folds so that when it heals, it blends into the natural appearance of the armpit. In addition, the incision is short and may not exceed 3 cm in length.
